Anesthesia for Cesarean Delivery in a Low-Resource Setting, an Initial Review

Background: Bearing in mind the recent advances in obstetric anesthesia, the safety of both mother and child is of paramount importance, especially in a setting where resources are limited. We set out to find the pattern of cases presenting for cesarean delivery and the types of anesthesias provided for the management of these patients. Methods: A retrospective survey was conducted involving all anesthetics provided for cesarean delivery from January 2006 to December 2009 in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Information such as age, indications and anesthetic technique, including drugs used, were extracted from patients’ records. Data were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) version 17.0. Results: There were a total of 577 anaesthetics conducted for cesarean delivery during the period under review out of 4277 live births, giving a cesarean delivery rate of 13.5%. General anesthesia (GA) was administered on 266 (46%) of these patients, while 279 (48%) cases were done under subarachnoid block(SAB). 16 (3%) patients had combined GA and SAB, while 16 (3%) patients received epidural anesthesia. There were 302 emergency cesarean deliveries out of 577 cases, giving an emergency cesarean delivery rate of 52%. The commonest indication for cesarean delivery was two previous cesarean deliveries. Conclusion: A large percentage of our obstetric cases are being done under general anesthesia. Though majority of the conducted regional anesthesia were spinals (SAB), only a few cases were done under epidural block. Subspecialty training of anesthetists will go a long way to improve the current trends.